Inspection

Precordium

Ant. Aspect of Chest which ovelies the ht.

N precordium has a smooth contour, slightly convex.

Bulging:

• Enlarged ht

• Pericardial effusion

• Mediastinal tumor

• Pleural effusion

Flattened:

• Fibrosis of lung

• Old Pleural / Pericardial effusion

• Congenital deformity

APEX PULSE

• Lower most and outer most part of cardiac impulse seen.

• N it is in the 5th left ICS just inside midclavicular line.

PULSATIONS

• Lt parasternal à RVH , aneurysm of aorta

• Epigastric à RVH , liver pulsation.

• II ICS à dilated pulm. Artery , aneurysm aorta

• Suprasternal à AR , Coarctation of aorta , Hyper kinetic state

• Rt side of chest à dextrocardia

Dilated Veins Over The Chest Wall

• Intrathoracic obst.

• SVC and IVC obst.

• Rt sided ht failure.